For tattoo removal, does it make sense to mix Pico laser and q-switch?

Question

I had q-switch laser treatments on a tattoo at least 10 times before I gave up and did a cover up. I have several other tattoos that I have scheduled for a pico session. I wonder if alternating with the q-switch after the bulk of the ink is gone would be helpful for getting the colors the pico laser has trouble with.

Laura Riehm, MD · Answer

Thanks for your question.  Sorry, there isn't much you can do to speed up the tattoo removal process.  The cheaper nanosecond/q-switch lasers will take more treatments than a picosecond.  You are more likely to have complications from nanosecond tattoo removal treatments.  A picosecond laser with 755 and 532nm wavelengths can tackle all ink colors except for white ink.  After using a PicoSure laser for almost 3 years, you can't speed up the process.  Quality, professional tattoos take usually at least 18 months to remove.  Home-made tattoos can usually be removed in 6-12 months.  If you want to minimize the number (and expense) of laser tattoo removal sessions, wait up to 6 months between treatments.  We found that your body will chew up the ink for up to 6 months.  Best of luck.

Brian Citro, MD · Answer

It is very common to use both types of lasers. Many practices have both types and some of the pico lasers also have combines pico and Q-switch built in. My recommendation is that you find a practice that has both. Best of luck.

Mark Taylor, MD · Answer

Mixing Picosecond lasers with Q-Swtiched laser is something we do all of the time.  We have two pico laser and 4 Q-Swtiched laser and a new laser that shoots both pico and Q-Swtiched a the same time. Fotona Starwalker laser.  Some tattoo pigments respond better to Nano that Pico and the opposite is also true.  Having multiple technologies and wavelengths as well as lasers with different pulse durations helps to achieve fast and better tattoo removal.  The new Fotona Starwalker laser also has a factional mode that drills fine deep holes through the tattoo before using the standard handpieces to treat the ink.

Steven F. Weiner, MD · Answer

As you probably know, there are multiple lasers on the market that include both pico and nano (qs) capabilites such as the Piqo4, Picoway, and Enlighten. It makes perfect sense to start with an aggressive QS laser and then go to picoseond pulse durations. I find that with the Piqo4 laser, the power of the QS laser is much higher than all the others on the market and can clear most of the tattoo. The picosecond pulse duration helps to clear the tattoo ink as well. I will often use both in the same session using the R0 protocols.

For tattoo removal, does it make sense to mix Pico laser and q-switch?

Answers (4)

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